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Brachytherapy for uterine cervix-limited acute myeloid leukemia relapse. J Contemp Brachytherapy 2022; 14:601-604. [PMID: 36819473 PMCID: PMC9924153 DOI: 10.5114/jcb.2022.123980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/25/2022] [Indexed: 01/18/2023] Open
Abstract
Acute myeloid leukemia (AML) may extend to extra-medullary sites at diagnosis or at relapse, either isolated or associated with bone marrow disease. Granulocytic sarcoma of uterine cervix is rare, and there is no established treatment for this disease. Two cases of uterine cervix-limited AML relapse showed that brachytherapy may be an effective therapeutic option in this setting along with chemotherapy, with good tolerance.
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Shatilova A, Girshova L, Zaytsev D, Budaeva I, Mirolyubova Y, Ryzhkova D, Grozov R, Bogdanov K, Nikulina T, Motorin D, Zammoeva D, Efremova S, Ivanov V, Petukhov A, Alekseeva Y, Zaritskey A. The myeloid sarcoma treated by Venetoclax with hypomethylating agent followed by stem cell transplantation: rare case report. BMC Womens Health 2021; 21:184. [PMID: 33933047 PMCID: PMC8088676 DOI: 10.1186/s12905-021-01328-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/22/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Myeloid sarcoma (MS) is a very rare condition, develops both in patients with other hematological neoplasms, and as isolated tumor. MS of the gynecologic tract is extremely rare. An available literature data about diagnosis and management of MS is summarized in the article. The role of chemotherapy, radiation therapy, surgery and bone marrow transplantation in the treatment is discussed. Polychemotherapy and allogeneic bone marrow transplantation were suggested to be the optimal treatment strategy of MS of the gynecological tract. The use of new targeted agents results in promising clinical data. CASE PRESENTATION We are presenting a rare clinical case of a MS of the uterine cervix with concomitant bone marrow involvement and describe all the peculiarities of the clinical course, diagnosis, and treatment. The patient received chemotherapy followed by allogeneic bone marrow transplantation. The pre-transplant therapy allowed us to perform allogeneic bone marrow transplantation with the deepest response possible: complete PET-negative and MRD-negative remission of the disease. CONCLUSIONS MS remains a subject of discussion regarding its diagnostic and therapeutic aspects. The use of novel targeting agents can be perspective option for patient with extramedullary disease.
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Affiliation(s)
- Aleksina Shatilova
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341.
| | - Larisa Girshova
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Daniil Zaytsev
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Irina Budaeva
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Yuliya Mirolyubova
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Darya Ryzhkova
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Roman Grozov
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Konstantin Bogdanov
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Tatiana Nikulina
- Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Dmitriy Motorin
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Darina Zammoeva
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Svetlana Efremova
- Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Vladimir Ivanov
- Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Alexey Petukhov
- Personalized Medicine Centre, Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Yuliya Alekseeva
- Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
| | - Andrey Zaritskey
- Almazov National Medical Research Centre, 2 Akkuratova Str., Saint Petersburg, Russian Federation, 197341
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Bai CR, Li X, Wang JS, Li JJ, Liu N, Fei Q, Li D, Yang Y. Diagnosis and surgical treatment of primary isolated aggressive lumbar myeloid sarcoma: a rare case report and review of the literatures. BMC Musculoskelet Disord 2021; 22:220. [PMID: 33627110 PMCID: PMC7905608 DOI: 10.1186/s12891-021-04066-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 02/09/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Myeloid sarcoma is a rare, extramedullary, solid tumor derived from immature myeloid cell precursors. It is most frequently accompanied by acute myelogenous leukemia, though infrequently found in non-acute myelogenous leukemia patients. The tumor may involve any part of the body, but the lumbar spine is seldom involved. The present case study aims to understand the diagnosis and surgical treatment of a rare primary isolated myeloid sarcoma of the lumbar spine causing aggressive spinal cord compression in a non-acute myelogenous leukemia patient. CASE PRESENTATION A 29-year-old man complained of an aggressive radiating pain to the lower extremities and moderate dysuria with a Visual Analogue Scale score that gradually increased from 3 to 8. Lumbar enhanced magnetic resonance imaging and computed tomography revealed a lumbar canal lesion at lumbar spine L2 to L4 with spinal cord compression. A whole body bone scan with fused single photon emission computed tomography/computed tomography demonstrated abnormal 99mTc-methylene diphosphonate accumulation in the L3 lamina and spinous process. No evidence of infection or hematology disease was observed in laboratory tests. Due to rapid progression of the symptoms and lack of a clear diagnosis, decompression surgery was performed immediately. During the operation, an approximately 6.0 × 2.5 × 1.2 cm monolithic, fusiform, soft mass in the epidural space and associated lesion tissues were completely resected. The radiating pain was relieved immediately and the dysuria disappeared within 1 week. Intraoperative pathological frozen section analysis revealed a hematopoietic malignant tumor and postoperative immunohistochemistry examination confirmed the diagnosis of myeloid sarcoma. CONCLUSIONS The primary isolated aggressive lumbar myeloid sarcoma is rarely seen, the specific symptoms and related medical history are unclear. Surgery and hematological treatment are effective for understanding and recognizing this rare tumor.
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Affiliation(s)
- Cheng-Rui Bai
- Department of Orthopedics, Beijing Friendship Hospital Affiliated of Capital Medical University, 95 Yong An Rd, Beijing, 100050, China
| | - Xiang Li
- Department of Orthopedics, Beijing Friendship Hospital Affiliated of Capital Medical University, 95 Yong An Rd, Beijing, 100050, China
| | - Jing-Shi Wang
- Department of Hematology, Beijing Friendship Hospital Affiliated of Capital Medical University, 95 Yong An Rd, Beijing, 100050, China
| | - Jin-Jun Li
- Department of Orthopedics, Beijing Friendship Hospital Affiliated of Capital Medical University, 95 Yong An Rd, Beijing, 100050, China
| | - Ning Liu
- Department of Orthopedics, Beijing Friendship Hospital Affiliated of Capital Medical University, 95 Yong An Rd, Beijing, 100050, China
| | - Qi Fei
- Department of Orthopedics, Beijing Friendship Hospital Affiliated of Capital Medical University, 95 Yong An Rd, Beijing, 100050, China
| | - Dong Li
- Department of Orthopedics, Beijing Friendship Hospital Affiliated of Capital Medical University, 95 Yong An Rd, Beijing, 100050, China
| | - Yong Yang
- Department of Orthopedics, Beijing Friendship Hospital Affiliated of Capital Medical University, 95 Yong An Rd, Beijing, 100050, China.
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Wang W, He H, Chen X, Zhang C. Primary bronchial myeloid sarcoma mimicking bronchogenic carcinoma: a case report. BMC Pulm Med 2019; 19:204. [PMID: 31703576 PMCID: PMC6839095 DOI: 10.1186/s12890-019-0975-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 10/28/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myeloid sarcoma (MS) rarely involves the bronchus, and primary bronchial MS has almost never been reported in mainland China. CASE PRESENTATION A 65-year-old female patient was admitted with a 3-month history of cough. She was initially diagnosed with bronchogenic carcinoma according to chest computed tomography (CT). However, after a biopsy was taken from the endobronchial lesion by bronchoscopy and further immunohistochemical analysis was performed, the diagnosis of MS was made. Because her bone marrow was normal and she had no history of haematologic diseases, we further considered the diagnosis of primary bronchial MS. The patient received chemotherapy with HAG regimens, and the original mass completely resolved, as confirmed by chest CT scan after 3 cycles of treatment. Meanwhile, no abnormalities were found on re-examination via bronchoscopy. CONCLUSIONS MS should be considered in the differential diagnosis in the presence of a suspicious pulmonary mass. Immunohistochemical analysis is necessary to confirm the diagnosis. Chemotherapy can lengthen the survival time for patients.
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Affiliation(s)
- Wang Wang
- Department of Internal Medicine, the First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Wuhu, 241000, China
| | - Hesheng He
- Department of Hematology, the First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Wuhu, 241000, China.
| | - Xingwu Chen
- Department of Respiration, the First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Wuhu, 241000, China
| | - Chenhong Zhang
- Department of Internal Medicine, the First Affiliated Hospital of Wannan Medical College, Zheshan West Road, Wuhu, 241000, China
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Granulocytic Sarcoma of the Uterus: A Rare Presentation of Extramedullary Relapse of AML and Importance of MRI. Case Rep Radiol 2014; 2014:501342. [PMID: 25614846 PMCID: PMC4293779 DOI: 10.1155/2014/501342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 12/19/2014] [Indexed: 11/18/2022] Open
Abstract
Granulocytic sarcoma (GS) is a solid tumor that is the extramedullary presentation of acute myelogenous leukemia, other myeloproliferative disorders, or myelodysplastic syndromes. Less commonly, it also may arise as an isolated mass. In this report, we describe a 23-year-old female patient, with a GS in the uterus and we stress the value of diffusion weighted imaging for the evaluation of uterine neoplasms. To our knowledge, our case is the first in the literature to report diffusion weighted imaging (DWI) findings of GS.
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Chen WY, Wang CW, Chang CH, Liu HH, Lan KH, Tang JL, Tien HF, Kuo SH, Cheng AL. Clinicopathologic features and responses to radiotherapy of myeloid sarcoma. Radiat Oncol 2013; 8:245. [PMID: 24148102 PMCID: PMC4016483 DOI: 10.1186/1748-717x-8-245] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 10/15/2013] [Indexed: 02/02/2023] Open
Abstract
Background To evaluate clinicopathological features, radiotherapeutic parameters, and their associations with responses to radiotherapy (RT) in patients with myeloid sarcoma (MS). Methods We reviewed 20 patients receiving RT for MS lesions (in 43 RT courses) and analyzed the patients’ clinicopathologic features and radiotherapeutic parameters, and their associations with complete responses (CR) to RT using Fisher’s exact test and univariate logistic regression analysis. Generalized Estimating Equation was used to analyze all 43 irradiated lesions and account for the correlations in RT responses among lesions from the same patient. Results We found that the underlying hematological diseases of the evaluated patients were acute myeloid leukemia (AML) in 14 patients (70%), chronic myeloid leukemia in 4 patients (20%), myelodysplastic syndrome with AML transformation in one patient (5%), and de novo MS in one patient (5%). Most patients (55%) received RT for MS at the time of relapse following bone marrow transplantation (BMT). The most common cytogenetic abnormality was t(8;21)(q22;q22). The median RT dose of 20 Gy (range 6–35 Gy), administered in 1.5-3.5 Gy fractions, provided a 63% CR rate. RT dose, sex, cytogenetics, and bone marrow status at the time of RT had no significant effect on CR. Younger age (<50 y, P = 0.06), BMT prior to RT (P = 0.05), and underlying AML (P = 0.05) were marginally associated with higher CR to RT. Conclusions Our results indicate that a modest RT dose (20-30 Gy) achieves good local control of MS. Age, previous BMT, and underlying hematologic disease can affect RT response.
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Affiliation(s)
| | | | | | | | | | | | | | - Sung-Hsin Kuo
- Division of Radiation Oncology, Department of Oncology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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Nonleukemic granulocytic sarcoma of knee: a case report. Case Rep Med 2011; 2010:235295. [PMID: 21209806 PMCID: PMC3014795 DOI: 10.1155/2010/235295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 11/18/2010] [Indexed: 11/29/2022] Open
Abstract
Granulocytic sarcoma (GS) is a rare extramedullary tumor composed of immature myeloid cells. It is usually associated with leukemia or other myeloproliferative disorders. It occurs very rarely without overt hematologic diseases. A 19-year-old man presented with left knee mass. Biopsy with pathological analysis showed lymphoma aspect. Immunostains yielded the diagnosis of GS with myeloperoxidase and CD43 positivity. There was no systemic manifestation of leukemia, and bone marrow biopsiy was negative for neoplastic infiltration. Chemotherapy by CHOP was efficient, and the patient remaind alive and healthy 40 months after the end of treatment. The case is discussed in the framework of the existing literature about the diagnosis, treatment, and prognosis of this very rare condition.
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